Organization
AC ASSISTED LIVING
Active
Other names
AC Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
HELEN DIKE RN (DIRECTOR)
(480) 203-5862
Entity
Organization
Contact information
Practice address
3907 W. LANE AVE, PHOENIX, AZ 85051-5754
(623) 547-7232
(623) 215-2341
Mailing address
3907 W. LANE AVE, PHOENIX, AZ 85051-5754
(623) 547-7232
(623) 215-2341
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL10714H
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AL11475H
AZ DEPARTMENT OF HEALTH SERVICES
AZ
Enumeration date
05/04/2018
Last updated
02/24/2021
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